Medicare does not cover everything.
Are you expecting it to cover all of your health care needs?
If so, you are wrong.
According to a recent Kiplinger article titled “7 Things Medicare Doesn't Cover,” Medicare Parts A and B pay for medical care if you are age 65 or older, but they do not cover everything.
Most people can sign up for them three months before turning 65.
Part A will cover care in skilled nursing facilities, impatient hospital stays, certain home health care, hospice care, and surgery.
Part B is essentially medical insurance for outpatient care, hospice care, and preventative care.
Some medical supplies and equipment are also included.
What does it not over?
Any outpatient drugs are not covered.
Instead, you will need to purchase either a Medicare Advantage plan or a Part D prescription-drug policy.
You can sign up for these when you enroll.
You can also update these policies during open enrollment.
Medicare will cover some skilled nursing with limitations.
Custodial care is not covered.
What does this mean?
If you need help with daily tasks like bathing or dressing, Medicare will not cover these costs.
Instead, you should plan ahead and purchase a long-term care insurance policy or make other arrangements to cover these costs.
Deductibles and Co-Pays
Deductibles and Co-Pays are out of your own pocket.
What are these costs?
This year your Part A deductible would be $1,340 before coverage starts.
You will also be responsible for paying a portion of long hospital stay costs.
How much would this be?
It would be $335 per day for 61-90 days in the hospital.
If you are an in-patient longer than this, then you will pay $670 per day.
Medicare will only help pay a total of 60 days after the 90-day limit.
This is for a lifetime.
What does this mean?
If you stay in a hospital any longer, the entire cost must be paid by you.
Although Part B usually pays 80 percent of x-rays, lab tests, and services provided by your doctor, you will pay the remaining 20 percent after the 2018 deductible of $183.
How can you get help with the other portion?
You can get a Medigap policy or a Medicare Advantage plan.
By purchasing a Medigap policy within six months of signing up for your Part B plan, you cannot be rejected by insurers for pre-existing conditions.
The Majority of Dental Care
Routine dental care like checkup visits, fillings, teeth cleaning, dentures, or tooth extractions are not covered.
A Medicare Advantage plan does cover some costs for x-rays or basic cleanings.
Typically, there is an annual coverage gap.
Another option would be to purchase a dental discount plan or another dental insurance policy.
Basic Vision Care
Typically, Medicare does not cover eye exams or glasses.
Is there an exception?
It may cover those if associated with diabetes or after cataract surgery.
Some Medicare Advantage plans to provide coverage.
Research a plan to cover both dental and vision.
Hearing tends to deteriorate as you age.
You will need to select the right Medicare Advantage plan if you want fitting exams or hearing aids.
Other ways to help these expenses are to save money in an HSA before enrolling in Medicare.
Medical Care Overseas
Are you planning live abroad or visit a country overseas?
Medicare will not cover this.
There are limited exceptions.
You may receive coverage if you get ill on a cruise ship six hours from a U.S. port.
By purchasing a Medigap Plan C through G, M, and N, you could get coverage of up to 80 percent of emergency care abroad.
The lifetime limit would be $50,000.
You may also want to check and see if a Medicare Advantage plan covers emergency expenses abroad.
Another way to get coverage is to purchase a travel insurance policy to cover medical expenses abroad.
As you see, Medicare has its limitations.
You will need to research and plan ahead to develop a plan to meet your medical needs in retirement.
Remember: “An ounce of prevention is worth a pound of cure.” When making your financial, tax and estate plans, do not go it alone. Be sure to engage competent professional counsel.
For more information about estate planning in Overland Park, KS (and throughout the rest of Kansas and Missouri), visit our estate planning website and be sure to subscribe to our complimentary estate planning e-newsletter while you are there.
Reference: Kiplinger (May 23, 2018) “7 Things Medicare Doesn't Cover”